A heart valve may become defective or damaged from degeneration caused by congenital malformation, disease, aging, etc. When the valve becomes defective or damaged, the leaflets may not function properly to effectively stop blood flow when appropriate. One common problem associated with a degenerating heart valve is an enlargement, or dilation, of the valve annulus. These and other conditions can cause one or more of the leaflets to prolapse.
For example, when a mitral valve functions properly, the mitral valve prevents regurgitation of blood from the left ventricle into the left atrium when the ventricle contracts. In order to withstand the substantial backpressure and prevent regurgitation of blood into the left atrium during the ventricular contraction, the cordae tendinae hold the anterior and posterior leaflets in place across the opening of the annular ring. The cordae tendinae are fibrous cords that anchor the leaflets to the muscular wall of the heart and control the movement of the leaflets.
If the annulus of the mitral valve enlarges or dilates to a point where the attached leaflets are unable to fully close (malcoaptation) the opening, regurgitation may occur. Further, valve prolapse, or the forcing of the valve annulus and leaflets into the left atrium by backpressure in the left ventricle, may occur. Adverse clinical symptoms, such as chest pain, cardiac arrhythmias, dyspnea, may manifest in response to regurgitation or valve prolapse. As a result, surgical correction, either by valve repair procedures or by valve replacement, may be required.
Surgical reconstruction or repair procedures may include plication, chordal shortening, or chordal replacement. Another common repair procedure relates to remodelling of the valve annulus (e.g., annuloplasty), which may be accomplished by implantation of a prosthetic ring to help stabilize the annulus and to correct or help prevent valve insufficiency which may result from a defect or dysfunction of the valve annulus. Properly sizing and implanting an annuloplasty ring may substantially restore the valve annulus to its normal, undilated, circumference. In situations where the valve leaflets exhibit lesions, reconstruction of one or more valve leaflets by securing grafts or patches to the leaflets, such as over lesions or holes formed in the leaflet, may be necessary. The repair or reconstruction of the leaflets may be complicated and time consuming, the results of which are not readily reproducible.